Calendar: 1898-1899 Page 789

FACULTY OF MEDICINE civil II -Commentate on Cage in JiUtrictiu Α male plumber aged 39 attended the Out- patient Department at on December 17 complaining of pain in the abdomen and inability to pass his water Until few years previous he had been heavy drinker and up to the present time had suffered with pain after food and vomiting he had never suffered from haemaleme- sis nor melaena On the morning of December 17 while trying to pass water he was seized with violent pain and sudden all over the abdomen he was unable to pass his water then and since so that in all micturition had not occurred for 18 hours the bowels had acted regularly each day On examination the patient appeared pale and collapsed and the pulse was 124 small and thready The tongue was dry and brown and the patient asked for water which he drank greedily The abdomen was tympanitic to percussion in every part and there was no bladder dulness in the hypogastrium soft catheter passed readily into the bladder and half an ounce of deep orange-red urine shot out under high pressure The patient was at once admitted to the wards his temperature then being 982 On admission the abdominal pain became much more intense and the patient rolled from side to side in bed He constantly asked for water which was given him and also took some milk and beef-tea At he was obviously sinking and surgeon was summoned who at once attempted to pass catheter the catheter stopped short apparently at the entrance to the bladder by the rectum it was clear that the catheter had not entered false passage On further examination of the abdomen large amount of free fluid was detected shifting its position by gravity but all the rest of the abdomen was highly tympanitic By this time the patient was moribund and it was decided not to attempt an exploration Transfusion was diligently maintained but the patient sank quickly and died at Comment on this case what was its nature How would you connect the acute symptoms which led to his